Reporting to the Director of Risk Management, the Clinical Risk Manager is responsible for administering the risk management program and ensuring effective loss prevention/control and compliance with state, federal guidelines and UCSDH standards. The primary responsibility of this position is to administer UCSDH risk management program on a day-to-day basis, documenting, managing, and analyzing risk management data, conducting proactive risk assessments, conducting targeted risk management education, and providing risk management consultation with the objective of promoting patient safety and loss prevention activity in protection of organizational assets.

Description of Job Responsibilities:

• Initiates, coordinates, and manages all investigational and evaluation activities associated with professional liability occurrences, including conducting interviews, researching, and reviewing policies and procedures, reviewing of electronic medical record documentation and other information sources; analyzes potential and actual professional liability and general liability exposures and evaluates the extent and elements of exposure and recommends appropriate actions for risk mitigation.

• Follows an enterprise risk management framework (ISO 31000) in risk identification, analysis, evaluation, mitigation, and monitoring. Routinely identifies risk through risk assessments, observation, trended data, inspections, committee minutes, third party reports, attorney requests for medical records and administrative or associate referrals. Develops innovative approaches intended to reduce the frequency and severity of medical malpractice and patient injury claims.

• Manages incident reporting database documentation of reported events; monitors incident reporting system for patient harm events and unanticipated outcomes and investigates accordingly.

• Manages and implements the organization's risk management program in a manner that fulfills the mission and strategic goals of the organization while complying with state and federal laws and related accreditation standards. Reviews and/or drafts administrative policy and procedures that fall within the risk management domain. Submits reports to appropriate regulatory authorities as required.

• Provides clinical risk management consultation to all physician and employees insured by UCSDH. Prepares and presents reports to management regarding trends, patterns, and findings. Advises on the risk of current or future activities or programs conducted at the hospital. Establishes and coordinates committees and councils where indicated to manage high risk events.

• Facilitates legal consultation from the UCSDH Office of Campus Counsel to staff and physicians as indicated. Creates and provides education for employees and physicians in relevant risk management topics.

• Collaborates with assigned departments, Patient Safety, Quality/Performance Improvement, Patient Experience, etc. to establish quality and safety goals; participates on hospital quality and patient safety committees.

• Performs special projects that involve data gathering, preparation of reports, development of recommendations and presentations. Participates in professional organization programs throughout the risk management industry by presentation submissions, committee work, or other roles.

• Seven (7) years of related experience, education/training, OR a Bachelor's degree in related area plus three (3) years of related experience/training. Related experience: Risk Management, Clinical, quality, and/or legal work experience.

• Experience with and thorough knowledge of healthcare risk management practices, claims administration, and data analysis skills. Demonstrated ability to assess, monitor, investigate, and report.

• Nursing and/or Clinical experience.

• Certified Professional in Healthcare Risk Management (CPHRM).

• Must be able to work various hours and locations based on business needs.

• Employment is subject to a criminal background check and pre-employment physical.